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DOMINIQUE MECHELLE JACKSON
NPI 1679000814
Nurse Practitioner in Jackson, MS

Active since May 18, 2017PECOS EnrolledAccepts Medicare Assignment
766B LAKELAND DR, JACKSON, MS 39216(601) 982-2916(601) 366-2916 Get Directions Write a Review

NPPES record last updated: April 20, 2021. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Apr 20, 2021, May 18, 2017 (2 updates tracked since 2017).

About Dominique Mechelle Jackson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DOMINIQUE MECHELLE JACKSON (NPI 1679000814) is an individual nurse practitioner in Jackson, Mississippi, licensed in Mississippi (901975) and active in the NPI registry since May 2017. She is enrolled in Medicare PECOS and is a graduate of Other (2008).

NPPES Registry Identity

NPI1679000814
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameDOMINIQUE MECHELLE JACKSON
Location Address766B LAKELAND DRJackson, MS 39216-4610
Mailing Address766b Lakeland DrJackson, MS 39216-4610 · (601) 982-2916 · Fax (601) 366-2916
Phone(601) 982-2916
Fax(601) 366-2916
Sole ProprietorNo
Medical School CMSOtherGraduated 2008
Enumeration DateMay 18, 2017
Last NPPES UpdateApril 20, 20212 updates tracked since enumeration
NPPES CertifiedApril 20, 2021
✔ NPI 1679000814 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in MS · 901975
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
766B LAKELAND DR, Jackson, MS 39216
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dominique Mechelle Jackson is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2466720669
PECOS Enrollment IDI20210504000885
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
24 services12 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
14 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39216 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$80.50 typical visit price
range $51.65 – $159.18
Typical copayment $20.12 (range $12.91 – $39.79)
Most-billed visit code 99203
Established Patient
$92.20 typical visit price
range $16.15 – $129.61
Typical copayment $23.05 (range $4.03 – $32.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf L0642
DME-Orthotic Devices · category DF007N
1 supplier11 claims11 services$175.81 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dominique Jackson's NPI number?

The NPI number for Dominique Jackson is 1679000814. It was assigned to this individual provider in the NPPES registry on May 18, 2017.

Where is Dominique Jackson located?

Dominique Jackson practices at 766B Lakeland Dr, Jackson, MS 39216. The listed phone number is (601) 982-2916.

What is Dominique Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Dominique Jackson enrolled in Medicare?

Yes. Dominique Jackson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Dominique Jackson accept?

Health plans from UnitedHealthcare list Dominique Jackson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Dominique Jackson was last updated on April 20, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.